• Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
• Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more-severe condition such as a neurologic disorder or diabetes.
• Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn't empty completely.
• Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
• Mixed incontinence. You experience more than one type of urinary incontinence.

• pregnancy and childbirth
• menopause, as falling estrogen can make the muscles weaker
• hysterectomy and some other surgical procedures
• age
• obesity

• cystitis, an inflammation of the lining of the bladder
• neurological conditions, such as multiple sclerosis (MS), stroke, and Parkinson's disease
• enlarged prostate, which can cause the bladder to drop, and the urethra to become irritated

• an enlarged prostate gland
• a tumor pressing against the bladder
• urinary stones
• constipation
• urinary incontinence surgery which went too far

• an anatomical defect present from birth
• a spinal cord injury that impairs the nerve signals between the brain and the bladder
• a fistula, when a tube or channel develops between the bladder and a nearby area, usually the vagina

• some medications, especially some diuretics, antihypertensive drugs, sleeping tablets, sedatives, and muscle relaxants
• alcohol
• urinary tract infections (UTIs)

1. Bladder training, to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you're urinating only every 2.5 to 3.5 hours.
2. Double voiding, to help you learn to empty your bladder more completely to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.
3. Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.
4. Fluid and diet management, to regain control of your bladder. You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem.

 

1. Anticholinergics. These medications can calm an overactive bladder and may be helpful for urge incontinence. Examples include oxybutynin (Ditropan XL), tolterodine (Detrol), darifenacin (Enablex), fesoterodine (Toviaz), solifenacin (Vesicare) and trospium (Sanctura).
2. Mirabegron (Myrbetriq). Used to treat urge incontinence, this medication relaxes the bladder muscle and can increase the amount of urine your bladder can hold. It may also increase the amount you are able to urinate at one time, helping to empty your bladder more completely.
3. Alpha blockers. In men with urge or overflow incontinence, these medications relax bladder neck muscles and muscle fibers in the prostate and make it easier to empty the bladder. Examples include tamsulosin (Flomax), alfuzosin (Uroxatral), silodosin (Rapaflo), doxazosin (Cardura) and terazosin.
4. Topical estrogen. For women, applying low-dose, topical estrogen in the form of a vaginal cream, ring or patch may help tone and rejuvenate tissues in the urethra and vaginal areas. Systemic estrogen — taking the hormone as a pill — isn't recommended for urinary incontinence and may even make it worse.

• Pads and protective garments. Most products are no more bulky than normal underwear and can be easily worn under everyday clothing. Men who have problems with dribbles of urine can use a drip collector — a small pocket of absorbent padding that's worn over the penis and held in place by close-fitting underwear.
• Catheter. If you're incontinent because your bladder doesn't empty properly, your doctor may recommend that you learn to insert a soft tube (catheter) into your urethra several times a day to drain your bladder. You'll be instructed on how to clean these catheters for safe reuse.

1. Total Abdominal Hysterectomy: an original way to remove the uterus through a long abdominal skin incision, the recovery time after surgery may take longer than other methods.
2. Vaginal Hysterectomy: a surgical procedure to remove the uterus through the vagina. This technique is not suitable for some patients or conditions such as virgin women or enlarge uterus.
3. Laparoscopic Hysterectomy: a surgical procedure using laparoscope to guide the removal of the uterus. Conventional laparoscope hysterectomy requires only 3-4 tiny incisions (usually 0.5–1.0 cm) on the abdomen which results to less pain, shorter recovery period, and less scarring.
4. Scarless Laparoscopic Surgery: also called NOTES (Natural Orifice Transluminal Endoscopic Surgery) a new technique to operate through natural opening of human’s body, for women, surgeon will perform laparoscopic operation via vagina to remove the uterus. This technique is a true scarless surgery resulting to the best cosmetic advantage, less blood loss, faster recovery, and minimal complications.

1. an increase in menstrual bleeding, known as menorrhagia, sometimes with blood clots;
2. pressure on the bladder, which may cause frequent urination and a sense of urgency to urinate and, rarely, the inability to urinate;
3. pressure on the rectum, resulting in constipation;
4. pelvic pressure, "feeling full" in the lower abdomen, lower abdominal pain;
5. increase in size around the waist and change in abdominal contour (some women may need to increase their clothing size but not because of a significant weight gain);
6. infertility, which is defined as an inability to become pregnant after 1 year of attempting to get pregnant; and/or
7. a pelvic mass discovered by a health care practitioner during a physical examination.

• Irregular or heavy menstrual cycle, bleeding between periods
• Pelvic or abdominal pain
• Fever or night sweats
• Increasing abdominal girth
• Concerns about pregnancy or inability to become pregnant

• Menstrual bleeding soaking through more than 3 pads per hour
• Severe or prolonged pelvic or abdominal pain
• Dizziness, lightheadedness, shortness of breath, or chest pain associated with vaginal bleeding
• Vaginal bleeding associated with pregnancy or possible pregnancy

Cystoscopy (sis-TOS-kuh-pee) is a procedure used to see inside your urinary bladder and urethra — the tube that carries urine from your bladder to the outside of your body. During a cystoscopy procedure, your doctor uses a hollow tube (cystoscope) equipped with a lens to carefully examine the lining of your bladder and your urethra. The cystoscope is inserted into your urethra and slowly advanced into your bladder.

 

 

 

 

Areas that can be examined include:

 

• Urethra or urinary channel, which includes the prostate in men
• Bladder, which collects and stores urine
• The 2 ureters, which are small internal tubes that conduct the urine made by each kidney into the bladder
• A urologic surgeon, or urologist, performs cystoscopy. The procedure involves looking at the urinary tract from the inside. Abnormalities can be detected in this manner, and surgical procedures can be performed.
• You would commonly have cystoscopy for the evaluation of blood in the urine. There are many other indications for the procedure, including the evaluation of difficulty or painful voiding, bladder or urethral tumors, bladder stones, and prostate surgery.
• Simple procedures can be performed in the doctor's office with only a local anesthetic. Most procedures, however, are performed in a hospital operating room as an outpatient. A variety of different anesthetics can be used to make the procedure as comfortable as possible.

 

What is the Preparation for Cystoscopy?

 

Depending on the type of procedure being performed, your doctor may prescribe antibiotics for you. If the cystoscopy is going to be performed in the operating room with the use of anesthesia, the surgical department will contact you with instructions. Most of the time, you must not take anything by mouth after midnight the evening before the cystoscopy. In recent years, however, some anesthesiologists have started to allow the consumption of certain liquids up to 4 hours before the procedure.

 

 

 

 

For procedures being done with only a local anesthetic, no fasting requirement is necessary. Notify your doctor if you are taking any blood thinners, including warfarin (Coumadin), aspirin, and ibuprofen.

 

Recovering after a cystoscopy

 

Give yourself time to rest. Drink lots of fluids and stay close to the bathroom. Holding a damp, warm washcloth over your urethra can help relieve any pain. If your doctor gives you permission, take pain medications such as acetaminophen (Tylenol) or ibuprofen (Advil).

 

If you were given general anesthesia, have someone stay with you. after the procedure. You may feel sleepy or dizzy. Don’t drink alcohol, drive, or operate complex machinery for the rest of the day.

 

If you had a biopsy done, you’ll need time to heal. Avoid heavy lifting for the next two weeks. Ask your doctor when it’s safe to have sexual intercourse.

 

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• Ultrasounds – A number of ultrasounds are used for high risk pregnancy diagnosis. These include targeted ultrasounds, which can construct an image of your child in the womb, and target a suspected issue, like an abnormal fetal development.
• Blood Testing – A routine blood test may also be diagnosed, as it can indicate that you have an underlying condition, such as gestational hypertension. This can place you and your child at risk, and will require prenatal monitoring and treatment.
• Urinalysis – Conditions like preeclampsia can be diagnosed through this test, as it can detect excess protein in the u

• You lose consciousness – It wouldn’t be possible for you to take any action in this situation. Brief your partner, neighbour or colleague in advance of what to do in such a situation
• You experience vaginal bleeding
• You experience unbearable pain in your pelvis or belly
• You have fluid leaking from your vagina – This could be because the umbilical cord is bulging into your vagina. Call for emergency help immediately. Meanwhile, get down on your knees so that your rear end (buttocks) is higher than your head. This will help reduce the pressure on the cord until help arrives.

• urinary issues, such as the urge to urinate or painful urination
• constipation or bowel strains
• lower back pain
• pain in the pelvic region, genitals, or rectum
• discomfort during sexual intercourse for women
• pressure in the pelvic region or rectum
• muscle spasms in the pelvis

• childbirth
• traumatic injury to the pelvic region
• obesity
• pelvic surgery
• nerve damage

1. Biofeedback: The most common treatment for pelvic floor dysfunction is biofeedback, done with the help of a physical therapist. This non-painful, non-surgical technique provides improvement for more than 75% of people with pelvic floor dysfunction. Physical therapists may take several approaches to biofeedback to retrain the muscles. These include using special sensors and video to monitor the pelvic floor muscles as the patient attempts to relax or contract them. The therapist then provides feedback and works with the patient on improving his or her muscle coordination.
2. Medication: In some cases, your physician may prescribe a low-dose muscle relaxant to deal with pelvic floor dysfunction.
3. Relaxation techniques: Your physician or physical therapist may recommend relaxation techniques such as meditation, warm baths, yoga and exercises.
4. Surgery: If your physician determines your pelvic floor dysfunction is the result of a rectal prolapse (the tissue that lines the rectum falls down into the anal opening) or rectocele (the end of the rectum pushes through the wall of the vagina), surgery may be necessary. By using the defecating proctogram test, your physician should be able to determine if these conditions are causing your pelvic floor dysfunction. Occasionally, your surgeon may decide to inject Botox to relax the pelvic floor muscle.

• Severe and steady pain
• Pain that comes and goes (intermittent)
• Dull aching
• Sharp pains or cramping
• Pressure or heaviness deep within your pelvis

• Pain during intercourse
• Pain while having a bowel movement or urinating
• Pain when you sit for long periods of time

• Endometriosis. This is a condition in which tissue from the lining of your womb (uterus) grows outside your uterus. These deposits of tissue respond to your menstrual cycle, just as your uterine lining does — thickening, breaking down and bleeding each month as your hormone levels rise and fall. Because it's happening outside your uterus, the blood and tissue can't exit your body through your vagina. Instead, they remain in your abdomen, where they may lead to painful cysts and fibrous bands of scar tissue (adhesions).
• Musculoskeletal problems. Conditions affecting your bones, joints and connective tissues (musculoskeletal system) — such as fibromyalgia, pelvic floor muscle tension, inflammation of the pubic joint (pubic symphysis) or hernia — can lead to recurring pelvic pain.
• Chronic pelvic inflammatory disease. This can occur if a long-term infection, often sexually transmitted, causes scarring that involves your pelvic organs.
• Ovarian remnant. After surgical removal of the uterus, ovaries and fallopian tubes, a small piece of ovary may accidentally be left inside and later develop painful cysts.
• Fibroids. These noncancerous uterine growths may cause pressure or a feeling of heaviness in your lower abdomen. They rarely cause sharp pain unless they become deprived of a blood supply and begin to die (degenerate).
• Irritable bowel syndrome. Symptoms associated with irritable bowel syndrome — bloating, constipation or diarrhea — can be a source of pelvic pain and pressure.
• Painful bladder syndrome (interstitial cystitis). This condition is associated with recurring pain in your bladder and a frequent need to urinate. You may experience pelvic pain as your bladder fills, which may improve temporarily after you empty your bladder.
• Pelvic congestion syndrome. Some doctors believe enlarged, varicose-type veins around your uterus and ovaries may result in pelvic pain. However, other doctors are much less certain that pelvic congestion syndrome is a cause of pelvic pain because most women with enlarged veins in the pelvis have no associated pain.
• Psychological factors. Depression, chronic stress or a history of sexual or physical abuse may increase your risk of chronic pelvic pain. Emotional distress makes pain worse, and living with chronic pain contributes to emotional distress. These two factors often become a vicious cycle.

Chronic pain can have a major impact on your daily life. When you're in pain, you may have trouble sleeping, exercising or performing physical tasks.

 

Chronic pain can also cause anxiety and stress, which in turn may worsen your pain.

 

Relaxation techniques can help release tension, reduce pain, calm emotions and induce sleep. Many techniques can be learned on your own, such as meditation and deep breathing.

 

1. If a woman is having abnormal Periods.
2. If she is bleeding after Menopause.
3. To diagnose the presence of fibroids, polyps or scar tissues.
4. It can also help to determine any kind of uterine malformation.
5. Recurrent miscarriages.
6. If a biopsy is suggested.
7. As a part of an Infertility workup.
8. To locate the position of an Intrauterine Device (IUD).
9. In case of abnormal Pap smear test.
10. To perform sterilisation as a part of birth control.

 

 

• Uterine Fibroids
• Uterine Polyps
• Uterine adhesions
• Any malignant mass

1. You may have a problem with the anaesthesia given.
2. Though very rare, there may be tearing or damage to your cervix.
3. You may contract an infection of the uterus or fallopian tubes after the procedure.
4. Bleeding may occur, and there might be a uterine perforation.
5. You may face a problem with the carbon dioxide gas or saline solution that was inserted. Excessive fluid absorption by the body may cause nausea and vomiting,.
6. The hysteroscope could damage the nearby organs like the ovaries, bladder or bowels.
7. You could develop a Pelvic Inflammatory Disease.

What is laparoscopy ?

A laparoscopy is a diagnostic procedure.

A surgeon uses a thin device with an attached light and camera to help them more clearly visualize organ damage and disease.

During a laparoscopy, the healthcare provider inserts the laparoscope into the abdomen through a small incision in the abdomen. They will then use a catheter, allowing for clearer imaging of the organs in the abdomen and pelvis.

 

Purpose

A laparoscopy can take place for many reasons, health conditions, and diagnoses, including tubal ligation, diagnostic procedures, and the treatment of certain conditions.

 

Common reasons for undergoing a laparoscopy include:

the diagnosis and treatment of endometriosis, chronic pelvic pain, pelvic inflammatory disease, and causes of infertility

the removal of fibroids, uterus, ovarian cysts, lymph nodes, or an ectopic pregnancy

the treatment of a range of disorders, including urinary incontinence, pelvic organ prolapse, and certain forms of cancer

evaluating certain cancers, including those of the ovary, uterus, and cervix.

 

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Gynecologists are doctors who specialize in women's health, with a focus on the female reproductive system.

They deal with a wide range of issues, including obstetrics, or pregnancy and childbirth, menstruation and fertility issues, sexually transmitted infections (STIs), hormone disorders, and others.

 

In the United States, some women prefer to visit a well-woman clinic rather than a family doctor for general health issues. The gynecologist may then refer the patient to another specialist.

 

A qualified gynecologist has at least 8 years of training and should be certified by an examining body, such as the American Board of Gynecologists (ABOG) and registered by a professional organization, such as the American College of Obstetricians and Gynecologists (ACOG).

 

Fast facts about gynecologists:

Here are some key points about gynecologists. More detail is in the main article.

A gynecologist is a doctor who specializes in the health of the female organs.

Many women start visiting a gynecologist from their early teens and continue to attend a well-woman clinic for general health issues too.

Women are advised to visit a gynecologist annually for a checkup, and any time they have symptoms that concern them.

A gynecologist should be certified and registered with a professional body, such as the American College of Obstetricians and Gynecologists (ACOG).

 

 

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